
The purpose of this paper is to understand Panic Disorder and symptoms, types of the disorder, treatment, and relation to other disorders and how it affects people in general. Included, is a case study of �Sarah� who suffered with a panic disorder. 
Panic Disorder is when someone experiences unexpected panic attacks followed by at least one month of persistent concern about having another panic attack, worrying about the possible consequences of the panic attacks, or a behavioral change related to the attacks (Millon, 1996, p.559). Panic Disorder is not a disease. It may be assessed, but not definitively diagnosed. This disorder is distressing and disabling, physically, psychologically, and socially (Harvard, 2000, p.1).
One symptom of Panic Disorder is unexpected panic attacks. At least two panic attacks are required for diagnosis. Attacks may last from several seconds to several minutes. Doctors believe that every attack has a situational trigger and an essential feature (Morrison, 1995, p.402). Another symptom of the disorder is constant concern and worry. The most common trait found in all Panic Disorder patients is a fear of being embarrassed. When a person takes an attack once they are paranoid for up to three months about going into public for fear of taking another attack. People diagnosed with panic disorder experience great anticipation and are very anxious when they look forward. They often worry and think of the worst possible outcomes, and at night, nightmares often occur. Panic disorder patients often assume that they have an undiagnosed disease or think they are going crazy (Harvard, 2000, p.8). 
Sarah, also experienced severe anxiety in social situations. She had a terrible fear of having another attack, fear of losing consciousness, and a fear of embarrassment in social situations. Sarah had suffered in her sleep as well. Constant nightmares persisted, causing lack of sufficient sleep. Sarah felt she was going crazy, because of the fact that she didn�t know what was wrong with her. 
One symptom of this disorder is behavioral change. Depression is a very common trait in people who suffer with panic disorder. The rate of attempted suicide is twenty times higher among individuals with panic disorder than the general population (Morrison, 1995, p.403). Many people with panic disorder also suffer from alcoholism. People with panic disorder often have great anticipation. 
Physical conditions are another one of the symptoms of panic disorder. Panic disorder effects physical features of a persons body such as high blood pressure, loss of bladder control, chemical change in ones body, prolapsed and thyroid disease. During the attack a person can experience excessive sweating, chills, chocking, shortness of breath, hot flashes, nausea and pains in their chest. Dizziness, shaking and pounding of the heart are also physical features of this disorder (Laliberte, 1998, p.117). 
During Sarah�s attacks, she experienced many of these physical symptoms. She had shortness of breath, hot flashes, pains in the chest, dizziness (causing her to pass out at times), and shaking and pounding of the heart. She felt as though the attack overpowered her thoughts or feelings, overwhelming her. 
In this paper we are going to look at four different types of Anxiety Disorders. The first type is Anxiety Disorder due to a general medical condition. Anxiety Disorder due to a general medical condition is diagnosed whenever a panic attack is thought to be a direct physiological consequences. Tests done on physical and mental health, help to determine what the role of the general medical condition is. The second type of Anxiety Disorder is Substance-Induced Anxiety Disorder. It is nearly the same as the first type mention, only instead of being a consequence of a medical disorder; it is a consequence of a substance. The substance could be a number of different things including a drug or medication. Nervous system depressants and stimulants can also trigger a panic attack (Morrison, 1995, p.401). 
The third type of anxiety disorder is Obsessive-Compulsive Disorder. There are many people who suffer with this type. Whenever someone has an obsession and views an object that triggers their obsession it could lead straight into a panic attack. An example is someone who is obsessed with cleanliness; the item that triggered the attack could possibly be dirt. The last type of Panic Attacks that will be discussed is Separation Anxiety Disorder. This is when other disorders are associated with Panic Disorder. It could be anything as little as embarrassment, to fear of elevators or heights, or Social Phobia (Morrison, 1995, p.401). 
There are certain people effected by Panic Disorder because some factors create susceptibility to Panic Disorder. In many cases Panic Disorder is hereditary. The risk for other members in the same family is anywhere from ten to twenty percent. Identical twins have a high risk of getting Panic Disorder Thirty percent of Identical twins are diagnosed with it. Sarah�s Mother suffers with Panic Disorder, and also has an identical twin (Harvard, 1996, p.1).
Age is also a factor involved. The age of those that suffer from Panic Disorder usually ranges between late adolescence to people in their mid thirty�s. It also affects more women then men. Actually, two to three times as much woman suffers from it than men. Men don�t seem to have as many attacks as women because they don�t often try to find help in dealing with their emotions. So they attempt to treat themselves instead. People with Epilepsy also seem to have a higher rate of having panic attacks. Sarah�s attacks started in late adolescence, when she was sixteen years old. 
There are different types of treatments such as cognitive behavioral therapy. CBT teaches patients how to manage their anxiety and how not to think of anxiety-provoking thoughts. Cognitive behavioral therapy usually takes three to six weeks to work. Panic sufferers can also use a therapy known as exposure therapy, which teaches a person that he or she can control their symptoms. First, the therapist puts symptoms of a panic attack in an office setting. Then he coaches the patient in methods of cognitive-behavioral therapy. Behavioral therapy is meant to help patients confront fearful situations (FDA consumer, 1992 p.22). Another treatment used is plain supportive, sympathetic listening. 
The last kind of treatment is Medication. Medications are a way to get Panic Disorders under control. However, some people become very dependant on these drugs because they are antidepressants. Sixty percent of people, who stop taking medication after the first year, are back on the medication by there third year. Only one drug named alprazolam had ever came on the market for successfully treating panic disorder. There have been other drugs such as Xanax and Klonopin, which have said to reduce panic attacks (FDA consumer, 1992, p.22). Sarah has been on paxil (paroxetine) for about three years now and has used cognitive behavioral therapy to take control of her situations. Medications and cognitive-behavioral therapy can effectively reduce or prevent panic attacks in anywhere form seventy to ninety percent of those who suffer from the disorder.
Of course, with every disorder or disease, there comes consequences. People suffering from Panic Disorder usually have trouble with their social and marital relationships. It gives a person poor physical, as well as mental health. If a person suffering with panic attacks use alcohol or if they are taking drugs it can lead to an increased risk of suicide attempts (Grewal, 1992, p.57).
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